If you've been told you have chronic kidney disease (CKD), or your doctor has mentioned your kidneys aren't working as well as they should, this page explains what that means, why it matters, and what you can do. It is not medical advice — your GP knows your situation.
The most important thing to know: CKD usually has no symptoms in the early stages. People often don't know they have it until a routine blood or urine test picks it up. The good news — if it's found early, the progression can be slowed dramatically, often for decades. That's why your doctor is taking it seriously.
What CKD means
Your kidneys filter your blood, removing waste products and extra water that become urine. Each kidney is about the size of a fist, but together they filter around 180 litres of blood per day. They also help control blood pressure, make red blood cells, and keep your bones healthy.
Chronic kidney disease means there's been some loss of kidney function or some sign of kidney damage that's been present for more than three months. It can range from very mild (no symptoms, kidneys still doing most of their work) to advanced (needing dialysis or transplant). Most Australians with CKD are in the milder stages and never need dialysis — especially when treatment starts early.
How CKD is diagnosed
There are three checks your GP does — together they're called a Kidney Health Check:
Blood pressure — high BP both damages and is caused by kidney problems.
Urine ACR (albumin-to-creatinine ratio) — checks for protein in the urine, which is one of the earliest signs of kidney damage. Just a simple spot sample.
Blood test for eGFR — estimates how well your kidneys filter. Calculated from your serum creatinine.
If any of these is abnormal, your GP will repeat the test 3 months later — a single abnormal result isn't enough to diagnose CKD. Many things can cause a one-off abnormal kidney test (dehydration, infection, certain medications).
CKD stages
Your GP may have mentioned a "stage" of CKD. The stages are based on your eGFR — the lower the number, the more advanced the disease:
Stage
eGFR
What it means
Stage 1
≥ 90
Normal filtering, but kidney damage present (e.g. protein in urine)
Stage 2
60–89
Mildly reduced filtering with kidney damage
Stage 3
30–59
Moderately reduced filtering — most people with CKD are here. More on Stage 3 →
Stage 4
15–29
Severely reduced filtering — usually under kidney specialist care, preparing for possible dialysis
Stage 5
< 15
Kidney failure — dialysis or transplant needed
The stage is part of the picture — your GP also looks at the protein in your urine (ACR) and how stable your numbers are over time. Two people at "Stage 3" can have very different outlooks depending on these other factors.
Who's at higher risk
Kidney Health Australia recommends a yearly Kidney Health Check for anyone with one or more of:
Diabetes (type 1 or 2)
High blood pressure
Heart disease, stroke, or peripheral artery disease
Family history of kidney failure
Age 60 or older
First Nations Australian aged 18 or older (CKD is twice as common — annual check from age 18)
Obesity (BMI ≥ 30)
Current smoker
History of acute kidney injury
Recurrent urinary infections, kidney stones, or one kidney only
What you can do
The single most important thing: treat the cause of the CKD if you can. For most Australians that means controlling blood pressure, diabetes, and weight — these account for most CKD cases. Beyond that, there are practical daily things that help:
Control your blood pressure
High blood pressure both causes and worsens CKD. Your GP will aim for a target depending on your situation (usually under 140/90, or under 130/80 if you have protein in your urine). Take your medications even when you feel well.
Take your kidney-protective medications
For people with CKD plus protein in their urine, two classes of medication are especially protective: ACE inhibitors / ARBs (often prescribed for blood pressure but they also protect kidneys), and SGLT2 inhibitors (originally for diabetes but now used in non-diabetic kidney disease too). Common Australian names: dapagliflozin, empagliflozin. Take them as prescribed.
Avoid NSAIDs (anti-inflammatory painkillers)
Ibuprofen, naproxen, diclofenac, mefenamic acid — whether prescription or over-the-counter (Nurofen, Voltaren, Advil). They can damage kidneys, especially in combination with blood pressure medicines. Paracetamol is generally safe in CKD when used as directed. Tell every doctor, pharmacist, and dentist you see that you have CKD before they prescribe anything.
Watch your salt
Aim for under 5 g of salt per day (about a teaspoon). Most of the salt in our diet comes from processed foods, takeaway, bread, sauces, soups — not the salt shaker. The salt estimator can help.
Drink water to satisfy thirst
In early CKD you don't need to drink extra litres — just enough to satisfy thirst. In advanced CKD your specialist may give you a fluid limit. Kidney-friendly eating →
Stay active & manage weight
150–300 minutes per week of moderate exercise (walking, swimming, cycling). Weight loss if overweight — even modest loss helps.
Flu, COVID, pneumococcal — people with CKD are at higher risk of complications from infections. See the vaccine eligibility checker.
Sick-day rules
If you become unwell with vomiting, diarrhoea, or significant dehydration, some of your medications can stress the kidneys when there's not enough fluid in your body. Your GP may have given you a "sick-day plan" telling you which medications to temporarily stop until you're eating and drinking normally again for a day or two. Ask your GP about this in advance — not when you're already unwell.
Common medications to consider holding when unwell (only on your doctor's advice): diuretics ("fluid tablets"), ACE inhibitors / ARBs, metformin, SGLT2 inhibitors, and any NSAIDs. Don't stop your medications without talking to your GP or pharmacist.
When to call your GP
You're unwell with vomiting, diarrhoea, or can't keep fluids down for more than 24 hours — ask about sick-day rules
New swelling in your legs, ankles, or face
You're noticing your urine looks different (foamy, very dark, blood-stained, or much less than usual)
Increasing tiredness, breathlessness, or trouble concentrating
You're prescribed any new medication, especially anti-inflammatories or antibiotics
You're going to have a scan with contrast dye (the radiology team needs to know about your kidneys)
When to call 000 / go to ED
You suddenly can't pass urine at all
Severe breathlessness or chest pain
Suddenly very confused, drowsy, or hard to wake
Severe vomiting or diarrhoea with signs of dehydration in someone on multiple medications
Common questions
For most people with CKD, the answer is no. Most CKD doesn't progress to needing dialysis — especially when blood pressure, diabetes and protein in the urine are well controlled. Even at Stage 3 (where most CKD diagnoses are made), most people will not need dialysis in their lifetime. If you're at risk of progression, your GP and nephrologist will plan well in advance — including options like home dialysis, in-centre dialysis, transplant, or conservative care.
Damaged kidneys generally don't regenerate — but progression can be slowed dramatically. In some cases (e.g. when the cause was poorly controlled blood pressure or a one-off illness), kidney function can recover partially. The aim isn't to reverse the damage — it's to stabilise where you are and prevent further loss.
In early CKD, no — a sensible Australian diet (Mediterranean-style is well-evidenced), lower salt, lots of vegetables, sensible portions, limited processed food, water to drink. In more advanced CKD (Stage 4 or 5), your GP may refer you to a renal dietitian for specific advice on potassium, phosphate, and protein. Don't restrict things on your own — ask first.
Alcohol in moderation is generally OK in early CKD, but it's worth checking with your GP. The Australian guidelines suggest no more than 10 standard drinks per week, with two alcohol-free days. Less is better — especially if you have high blood pressure or diabetes alongside the CKD.
Most CKD isn't inherited — it's caused by things like diabetes and high blood pressure that run in families partly through genetics and partly through shared lifestyle. A few rarer kidney conditions (like polycystic kidney disease) are directly inherited. If your CKD has a strong family pattern or unusual features, your nephrologist may discuss genetic testing. Your close relatives are at higher risk and should have a Kidney Health Check.
👩⚕️ For clinicians: see the CKD management reference — KHA action plan, BP targets, SGLT2i, sick-day rules, when to refer.
Support and resources Kidney Helpline — 1800 454 363 (free, business hours) Kidney Health Australia — kidney.org.au — patient information, peer support, kidney risk test First Nations resources — kidney.org.au/first-nations Quitline (if you smoke) — 13 7848 Lifeline (if you're struggling emotionally with the diagnosis) — 13 11 14